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By Debbie Gregory.

The Congressional Budget Office (CBO) periodically issues a volume of options that would decrease federal spending or increase federal revenues. In December, the CBO published its list of 121 options to combat the projected $1 trillion federal deficit this year, among them three suggestions on TRICARE and six that address veterans’ benefits.

In its most recent volume, entitled “Options for Reducing the Deficit: 2019 to 2028”, the CBO suggested raising TRICARE enrollment fees for military retirees, instituting enrollment fees for TRICARE for Life and reducing veterans’ benefits.

The publication marks the fourth time in five years that the CBO has suggested raising TRICARE enrollment fees for working-age retirees and introducing minimum out-of-pocket expenses for those using TRICARE for Life.

In order to save nearly $12 billion, CBO suggested increasing TRICARE enrollment fees, deductibles and co-payments for working-age military retirees.

“Beneficiaries with individual coverage would pay $650 annually to enroll in TRICARE Prime. The annual cost of family enrollment would be $1,300,” the report stated. “All beneficiaries who enroll in TRICARE Select would pay an annual enrollment fee of $485 for individual coverage and $970 for a family.”

The CBO also suggested instituting enrollment fees for TRICARE for Life, the program that serves as supplemental coverage for military retirees on Medicare. Analysts estimated that the Defense Department could save $12 billion between 2021 and 2028.

According to CBO analysts, these options would reduce the financial burden of TRICARE for Life to the DoD in two ways: It would cut the government’s share by the amount of fees collected and indirectly would save money by causing some patients to forgo TRICARE for Life altogether, either by buying a private Medicare supplement or simply going without one.

According to the CBO, the Department of Veterans Affairs also presents several opportunities for cost-savings measures, including tightening up disability compensation requirements and disallowing benefits for arteriosclerotic heart disease, chronic obstructive pulmonary disease, Crohn’s disease, hemorrhoids, multiple sclerosis, osteoarthritis, and uterine fibroids. Additionally, the CBO recommends discontinuing the VA’s individual employability payments, reducing disability benefits to veterans older than 67 who are receiving Social Security payments, and eliminating disability compensation for veterans with disability rates below 30 percent.

The CBO also recommended making VA disability payments taxable income.

To all of the above, we say NO! Veterans have earned their benefits, and those benefits should be off the table.

Uniform Services May Eliminate Over 17,000 Medical Jobs

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By Debbie Gregory.

The U.S. military is reportedly finalizing plans to eliminate more than 17,000 uniformed medical professionals, including physicians, dentists, nurses and other healthcare professionals, resulting in a 13 percent cut to its medical workforce.

“Part of this drill is to realign our people to the appropriate level of workload so that their skills, both for battlefield care and for beneficiary care, improve,” said one Defense Department official.

While senior officials discussed the reasons for the cuts, they declined to confirm exact figures, as those numbers will not be made official until the fiscal year 2020 defense budget is approved by the White House, and sent to Congress next month. If both branches approve the budget, the reductions will take effect in fiscal year 2021.

The reduction will allow a deepening of the workload of remaining medical billets at base hospitals and clinics to strengthen medical skills, as well as improving quality of care for beneficiaries, according to defense officials.

The staff cuts are worrisome for patient access, particularly to physicians young families rely on such as pediatricians and obstetricians, according to retired Navy Capt. Kathryn M. Beasley, director of government relations for health issues at the Military Officers Association of America.

“We need to see the final numbers to understand the impact,” she said.

But senior defense officials, who say they collaborated closely with the services on overall staff reduction plans, contend the current force is larger than needed to meet today’s operational missions and is overloaded with skill sets not useful for deployment and delivering of battlefield care.

Defense officials conceded the staff cuts, and refocusing on deployable skills, over time will change the mix of providers delivering care on base, forcing more family care off base and onto Tricare provider networks.

“We will expect to see an increase in certain skill sets [and] a decrease in other skill sets,” said one official. “More trauma surgeons, fewer pediatricians, for example. Those kinds of changes are right at the heart of what Congress has directed us to do.”

By Debbie Gregory.

The U.S. Air Force announced the award of three Evolved Expendable Launch Vehicle (EELV) Launch Service Agreements to Blue Origin, Northrop Grumman Innovation Systems, and United Launch Alliance.

The $500 million award to Blue Origin will be for development of the New Glenn Launch System. The $792 million award to Northrop Grumman Innovation Systems is for development of the OmegA Launch System. The $967 million award to United Launch Alliance will be for development of the Vulcan Centaur Launch System.

The Defense Department has the option to narrow it to two companies no later than 2020 that will then compete for future launches.

Blue Origin was awarded for the preliminary work and will build its New Glenn Launch System.

Northrop Grumman Innovation Systems will manufacture its OmegA Launch System.

United Launch Alliance, which is a joint venture between Lockheed Martin and Boeing, will develop its Vulcan Centaur Launch System.

With the Congressional mandate to transition away from reliance on foreign rocket propulsion systems, and the planned Delta IV retirement, the Air Force developed an acquisition strategy to accelerate National Security Space launch requirements.

“Our launch program is a great example of how we are fielding tomorrow’s Air Force faster and smarter,” said Air Force Secretary Heather Wilson in a statement. “We’re making the most of the authorities Congress gave us, and we will no longer be reliant on the Russian-built RD-180 rocket engine.”

“Leveraging domestic commercial space launch systems is good for the Air Force, and a revitalized commercial launch industry is good for the taxpayer,” Wilson added.

While the prototypes are being developed, the Air Force will continue to competitively award commercial launch services contracts to providers who demonstrate the capability to design, produce, qualify and deliver launch systems and provide the mission assurance support required to deliver National Security Space satellites to orbit.

“I’m excited to announce these creative partnerships that directly support the Air Force’s strategy to drive innovation and leverage commercial industry,” said Dr. William Roper, Assistant Secretary of the Air Force for Acquisition, Technology, and Logistics. “These awards are a leap forward in space launch capabilities, ensuring continued U.S. dominance in space,” Roper added.

Focus on Contractors, Not the Press and Media

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By Debbie Gregory.

Deputy Defense Secretary Patrick Shanahan believes that increased communication with defense contractors is a step in the right direction in order to optimize the Pentagon’s relationships with industry. The Defense Department’s No. 2 civilian, Shanahan manages the Pentagon and oversees the acquisition and budget efforts.

In a March 2 memorandum entitled “Engaging With Industry” Shanahan wrote: “Conducting effective, responsible and efficient procurement of supplies and services while properly managing the resultant contracts requires department personnel to engage in early, frequent and clear communications with suppliers.”

As the Trump administration sought to deepen relations between private industry and government, last April Defense Secretary Jim Mattis encouraged expanded Pentagon-industry relations.

The push for more Pentagon-industry communications comes after other top leaders have ordered restrictions on talking with the public and the press. Most recently, on March 1, U.S. Air Force leaders suspended all interviews, embeds, and base visits for media organizations “until further notice.”

Prior to that, in March 2017, the Chief of Naval Operations cautioned his people to be more careful in what they say in public, saying that he did not want to give adversaries useful information.

“Industry is often the best source of information concerning market conditions and technological capabilities,” Shanahan wrote. “This information is crucial to determining whether and how the industry can support the Department’s mission and goals.”

Shanahan believes that complying with ethical and legal limits “should not” cause defense and service officials to be reluctant to engage industry.

“The department’s policy continues to be that representatives at all levels of the department have frequent, fair, even and with industry on matters of mutual interest, as appropriate, in a manner that protects sensitive information, operations, sources, methods and technologies,” Shanahan wrote.

By Debbie Gregory.

Faced with criticism over how it awarded a contract to move computer systems to the Internet cloud, the Pentagon has slashed a nearly $1 billion contract down to no more than $65 million, while also scaling back the scope of the work. The revision will limit its use to only U.S. Transportation Command rather than the entire Defense Department.

The contract awarded to Herndon, Virginia-based REAN Cloud—an Amazon Web Services partner, has come under scrutiny by those who feel that the procurement wasn’t handled properly, charges that Pentagon officials strongly denied.

Pentagon spokesman Col. Robert Manning said that after reviewing the contract, the Defense Department decided that “the agreement should be more narrowly tailored” so that Rean would build a prototype service for a single agency, the U.S. Transportation Command, instead of many agencies within the military.

Oracle filed a bid protest with the Government Accountability Office last month that called the procurement “an egregious abuse” of the procurement process for a contract that it charged was “shrouded in secrecy.”

Additionally, the Pentagon was criticized because the original contract was awarded by the Defense Innovation Unit Experimental (DIUx ) which was created to procure the technology of Silicon Valley-type companies that mostly shy away from Pentagon work. DIUx is fast-moving to provide non-dilutive capital to companies to solve national defense problems, usually in under 90 days.

The procurement, a follow-on to a smaller competed contract, was awarded under an “other transaction authority,” a way for the Pentagon to procure goods and services quickly without being subject to the bureaucratic federal acquisitions process.

Critics of the “other transaction authority” process say such arrangements are not competitive and insufficiently transparent.

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